The following directions apply to Sakel's insulin shock treatment1 for schizophrenia as it was reported and developed at the university clinic at Vienna in 1933. This procedure occupies a unique position, and both the therapeutic results and the precautionary measures are dependent on purely empirical rules. These rules are particularly important because there has so far been no satisfactory explanation of the mechanisms involved in the insulin shock treatment.

The purpose of these directions is to establish a single standard method and a single standard descriptive terminology, so that the results of the treatment can be compared and determined. This should eleminate misunderstandings due either to variation in the procedure or to uncertainties involved in statistical tabulations.

The procedure is based on a consideration of the literature and on the clinical experiences gathered at the university clinic in Vienna (director: Prof. Otto Pötzl), the psychiatric institute Zofjówka Otwock, Warsaw